Fox Joanna
School of Allied Health and Social Care, Anglia Ruskin University, Cambridge, UK.
Community Ment Health J. 2025 Feb;61(2):213-220. doi: 10.1007/s10597-024-01230-5. Epub 2024 Feb 22.
This article uses autoethnography to explore the author's lived experiences of mental distress and how she has conceptualised and explained these symptoms to herself using both the biomedical and recovery models of care. Autoethnography is a process of personal reflection that enables connection between the personal and the political. Experiences of mental distress are recounted alongside the decision to reduce medication. This personal experience is then explored in the context of limited evidence base on the effectiveness of reducing medication and the situation in which prescribers often feel reluctant to recommend and support service users in these choices. Shared decision-making in medication management is introduced which is an approach which draws on the models of recovery and co-production challenging traditional biomedical approaches which locate the prescriber as expert. Moreover, the radical service user led model is highlighted, within which, the Hearing Voices Network and Open Dialogue offer alternative approaches which promote co-production and empowerment. The author connects the personal to the political and reflects on her dual identity as an expert-by-experience and social work academic. She details how she has drawn on biomedical explanations to describe her distress yet has been challenged by the recovery model throughout her journey of recovery. She concludes that her own position, in identifying herself as an academic and expert-by-experience is an important step in challenging notions of expertise and approaches to mental health care.
本文运用自我民族志来探索作者精神痛苦的生活经历,以及她如何运用生物医学护理模式和康复护理模式对这些症状进行自我概念化和解释。自我民族志是一种个人反思过程,能在个人与政治之间建立联系。文中讲述了精神痛苦的经历以及减少药物治疗的决定。然后,在关于减少药物治疗有效性的证据有限,以及开处方者往往不愿在这些选择上为服务使用者提供建议和支持的背景下,探讨这一个人经历。引入了药物管理中的共同决策,这是一种借鉴康复模式和共同生产模式的方法,挑战了将开处方者定位为专家的传统生物医学方法。此外,还强调了激进的服务使用者主导模式,在该模式中,“听见声音网络”和“开放对话”提供了促进共同生产和赋权的替代方法。作者将个人与政治联系起来,反思了自己作为有经验的专家和社会工作学者的双重身份。她详细描述了自己如何利用生物医学解释来描述自己的痛苦,但在整个康复过程中一直受到康复模式的挑战。她得出结论,她将自己定位为学者和有经验的专家这一立场,是挑战专业知识观念和心理健康护理方法的重要一步。